Melaena

Last updated: Monday, 20, December, 2010
CausesAppropriate Tests

The magnitude of acute blood loss and the likely cause should be determined on clinical grounds.

The initial Hb may be normal after acute severe haemorrhage. FBC (PCV), blood group, blood group antibody screen, compatibility testing.

See also Blood transfusion - recipient testing. Endoscopy with biopsy, as appropriate.

See also Rectal bleeding for fresh or accult blood loss.

Gastritis/gastric erosions

Gastric ulcer, especially

Duodenal ulcer

Oesophagitis/oesophageal ulcer

Oesophageal carcinoma 

See under Peptic ulcer.

Vascular malformations

Bleeding disorder 

Gastrointestinal bleeding is rare, in the absence of a local lesion, or drug effect.